10. Criminal justice


Many people with mental health issues live in prison, either on remand (before trial), or post-sentencing, known as “on HEP” (on His Excellency’s Pleasure). The prison service reports approximately 17,000 prisoners, more than double the 8,000 capacity, with overcrowding made worse by some urban prisons significantly overpopulated.173 In 2009 the number of prisoners was 15,300 people accommodated in prisons built to accommodate 5,500 people before the country’s independence in 1964.174

People alleged to have committed criminal offences and who are judged to be “of unsound mind” may be detained at forensic psychiatric facilities.175 Chainama Hills Hospital has one male forensic ward with a capacity of 20 and a further three female forensic beds. Another 30 forensic beds are in Livingstone. Discharge from these places happens only when the senior psychiatrist issues a report recommending discharge and a prison officer recommends release to the country’s President (unless a prisoner on remand is found not guilty, in which the person is freed).176 This system means that the detention of people with recognised mental health issues is dependent on the executive arm of the State, without any judicial oversight.

The President may issue a pardon. In 2012 approximately 200 prisoners were pardoned: none were forensic patients.177 The absence of any structured system of review, independent assessment, representation of patient’s views, or appeal mechanism leaves patients at risk of arbitrary detention.

Mental healthcare in prisons is minimal. Psychiatrists visit prisons in Lusaka every few months, and prescribe psychiatric medication. In 2011 the Global Initiative on Psychiatry, with MHUNZA’s involvement, undertook an assessment of the situation of prisoners with mental health issues in Zambia targeting four prisons including the forensic ward at the Chainama Hills Hospital. The resultant report concluded that mental health care, detection and treatment are generally unavailable in prisons.178

Representatives of the access to justice department of the Ministry of Justice told monitors that they have no system in place to support people with mental health issues within the judicial system. State-funded legal aid is provided upon request to people who the legal aid committee, court or the director of legal aid board assessed as having insufficient means to pay for a lawyer and when justice is served by providing representation.179 Lawyers are most often available only at the provincial level and there are not enough to meet demand.

No records are kept of the number of cases involving victims of crime who have mental health issues. Criminal justice professionals told monitors that victims with mental health issues are invisible for law enforcement agencies, a long way from the statutory requirement to ensure “equal and effective protection and equal benefit of the law without discrimination”.180

173 Interview with Prisons Secretary, Ministry of Home Affairs: 3 February 2014.

174 Aids and Rights Alliance, Prison Care and Counselling Association, and Human Rights Watch “Unjust and Unhealthy” (Zambia: April 2004).

175 Sections 160, 163 and 167(3) of the Criminal Procedure Code. The Zambian Paralegal Alliance Network is researching mental health issues within the criminal justice system. Interview with Phillip Sabuni: 25 January 2014.

176 Recommendations consider the availability of family support and supports within the community, and the ability of inmates to live independently in the community. It is notable that none of these facilities have any occupational therapy or rehabilitation programmes to prepare inmates for release.

177 Interview with nursing officer in charge of Chainama East forensic unit, 31 October 2012.

178 Global Initiative on Psychiatry, “Assessment of the situation of prisoners with mental illness in Zambia”, March 2011 (Unpublished). The assessment was conducted by Co Bleeker, Robert Hollander, Carola Koornneef from Global Initiative on Psychiatry, Sylvester Katontoka of MHUNZA and Godfried Malabeka from Prison Care and Counselling Association from 14 to 19 March 2011.

179 Sections 8, 9, 11 and 14 of the Legal Aid Act, 2005.

180 Article 8(2) of the Persons with Disabilities Act 2012.

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